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The Machined Surface Coronal (MSc) dental implant surface treatment offers practitioners an innovative way to take advantage of the best characteristics of both smooth and moderately rough implant surfaces. A machined coronal region of specific surface roughness provides resistance against plaque and biofilm accumulation, and enhances the efficacy of preventive maintenance measures, thereby decreasing the risk of peri-implantitis. Meanwhile, the complementary moderately rough portion assures the superior osseointegration of modern surfaces. This hybrid surface design enables more predictable treatment of patients suffering from progressive bone loss.

Challenge

Roughened implant surfaces have long been preferred over traditional machined surfaces, as a more complex topography has been conclusively proven to enhance and accelerate bone growth onto the implant. In particular, moderately rough surfaces (Sa of 1-2 µm), such as the Southern Implants alumina-blasted treatment, have shown optimal short- and long-term stability. Even though smooth surfaces showed perfectly acceptable osseointegration in the long run, the advent of rough surfaces gave rise to improved restorative protocols such as immediate loading, simplifying treatment for both clinician and patient.

Despite the best efforts of the clinician, however, some patients are destined to experience progressive bone loss after implantation, resulting in exposure of the coronal threads of the implant to the oral cavity. Compared to smooth surfaces, rough surfaces have a higher propensity to collect bacteria-harbouring plaque and biofilm – known to be significant contributing factors to the development of peri-implantitis. This compounding bone loss begins a vicious cycle of degenerative peri-implant health.

Standard protocol for preventive maintenance is to clean the exposed implant surface using a variety of methods such as chemical rinsing, mechanical brushing, or laser debridement. However, another disadvantage of rough surfaces is their resistance to cleaning, and any residual biofilm forms a foundation for rapid bacterial regrowth. Often the exposed threads need to be removed, or the implant is lost entirely.

Innovation

The Southern Implants MSc implant features a hybrid surface configuration, whereby the coronal 3mm and collar of the implant are left as-machined (i.e. smooth), while the remaining portion of the implant features Southern Implants’ moderately rough surface. This inventive design offers the best of both worlds – the bacterial resistance and amenability to cleaning of the traditional smooth surface, combined with the superior osseointegration of a modern and clinically proven rough surface.

Thus, in the unfortunate event that a patient suffers progressive bone loss after implantation, the previously inevitable slide into peri-implantitis can be slowed down or even stopped with standard preventive maintenance measures.

This design is particularly beneficial for compromised patients, i.e. those with a contra-indicated medical history, poor oral hygiene, or the elderly. By uniting two proven surfaces with different benefits in one implant, patients who in the past would have been advised against implant therapy can now also enjoy the benefits of a stable restoration.